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Acute knee clinics are effective in reducing delay to diagnosis following anterior cruciate ligament injury.

Knee 2021 May 9;30:267-274. Epub 2021 May 9.

Bradford Teaching Hospitals NHS Foundation Trust, Accident and Emergency Department MSK Service, Bradford Royal Infirmary, Bradford BD9 6DA, UK.

Background: Delays to diagnosis of anterior cruciate ligament (ACL) injury and specialist consultation continue to place patients at risk of early onset osteoarthritis. Incorporating acute knee clinics within a streamlined accident and emergency (A&E) pathway have shown potential in reducing delay but specific evaluative research is lacking. The aim of this service evaluation was to investigate the effectiveness of an acute knee clinic at one NHS Trust in the United Kingdom (UK), on reducing the delay to diagnosis of ACL injury and specialist consultation compared to a standard A&E pathway. Read More

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Structural neuroimaging phenotypes of a novel multi-gene risk score in youth bipolar disorder.

J Affect Disord 2021 Apr 28;289:135-143. Epub 2021 Apr 28.

University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.

Background: Bipolar disorder (BD) is among the most heritable psychiatric disorders, particularly in early-onset cases, owing to multiple genes of small effect. Here we examine a multi-gene risk score (MGRS), to address the gap in multi-gene research in early-onset BD.

Methods: MGRS was derived from 34 genetic variants relevant to neuropsychiatric diseases and related systemic processes. Read More

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Screening and identification of microRNAs from plasma-derived extracellular vesicles (EVs) of Dazu black goat (Capra hircus) in early pregnant stages.

Gene 2021 May 9:145706. Epub 2021 May 9.

College of Animal Science and Technology, Southwest University, Chongqing Engineering Research Center for Herbivores Resource Protection and Utilization, Chongqing 400715, P. R. China. Electronic address:

Previous studies have shown that extracellular vesicles (EVs) containing proteins, lipids, nucleic acids and other biological components exist in all kinds of body fluids. EVs, as an intercellular communication carrier, regulate the functions of its target cells by transporting biomacromolecules between cells. In this study, a total of six female Dazu black goats were divided into NP group (NP, non-pregnant group) and P30 (P30, 30-day pregnant group). Read More

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Clinical And Hemodynamic Outcomes Of Rapid-Deployment Aortic Bioprostheses.

Semin Thorac Cardiovasc Surg 2021 May 9. Epub 2021 May 9.

Division of Cardiac Surgery, University of Padova, Padova, Italy.

Aim of this retrospective, multicenter study was to evaluate early and mid-term clinical and hemodynamic results of patients who underwent surgical aortic valve replacement (SAVR) with Intuity rapid-deployment bioprostheses (RDB) (Edwards Lifesciences, Irvine, CA). We analyzed data from the Italian Registry of Intuity Valve (INTU-ITA registry) that is a national, real-world and independent from the industry registry. Preoperative variables were defined according to EuroSCORE and postoperative outcomes according to Valve Academic Research Consortium (VARC). Read More

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Impaired glucose-1,6-biphosphate production due to bi-allelic PGM2L1 mutations is associated with a neurodevelopmental disorder.

Am J Hum Genet 2021 May 5. Epub 2021 May 5.

de Duve Institute, UCLouvain, 1200 Brussels, Belgium. Electronic address:

We describe a genetic syndrome due to PGM2L1 deficiency. PGM2 and PGM2L1 make hexose-bisphosphates, like glucose-1,6-bisphosphate, which are indispensable cofactors for sugar phosphomutases. These enzymes form the hexose-1-phosphates crucial for NDP-sugars synthesis and ensuing glycosylation reactions. Read More

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Integrated OMICs unveil the bone-marrow microenvironment in human leukemia.

Cell Rep 2021 May;35(6):109119

Haematopoietic Stem Cell Laboratory, The Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK. Electronic address:

The bone-marrow (BM) niche is the spatial environment composed by a network of multiple stromal components regulating adult hematopoiesis. We use multi-omics and computational tools to analyze multiple BM environmental compartments and decipher their mutual interactions in the context of acute myeloid leukemia (AML) xenografts. Under homeostatic conditions, we find a considerable overlap between niche populations identified using current markers. Read More

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Quantitative proteomics analysis identifies salivary biomarkers for early detection of pregnancy loss in a Singaporean cohort - A pilot study.

Proteomics Clin Appl 2021 May 12:e2000068. Epub 2021 May 12.

Associate Professor, Singapore Oral Microbiomics Initiative, National Dental Research Institute Singapore, National Dental Center Singapore, Oral Health Academic Clinical Program, Duke NUS Medical School, Singapore.

Purpose: Early pregnancy loss (EPL) is one of the most common complications encountered in clinical practice. As most of EPLs occur relatively early on during pregnancy, they are often misunderstood as an expected menstrual cycle. Thus, it is essential to investigate the diagnostic biomarkers for monitoring pregnancy loss for continuous non-invasive monitoring of EPL. Read More

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'If relevant, yes; if not, no': General practitioner (GP) users and GP perceptions about asking ethnicity questions in Irish general practice: A qualitative analysis using Normalization Process Theory.

PLoS One 2021 12;16(5):e0251192. Epub 2021 May 12.

School of Medicine & Health Research Institute, University of Limerick, Limerick, Ireland.

Context: The use of ethnic identifiers in health systems is recommended in several European countries as a means to identify and address heath inequities. There are barriers to implementation that have not been researched.

Objective: This study examines whether and how ethnicity data can be collected in Irish general practices in a meaningful and acceptable way. Read More

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Extracellular vesicle-enriched miRNA profiles across pregnancy in the MADRES cohort.

PLoS One 2021 12;16(5):e0251259. Epub 2021 May 12.

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, United States of America.

MicroRNA (miRNA) circulating in plasma have been proposed as biomarkers for a variety of conditions and diseases, including complications during pregnancy. During pregnancy, about 15-25% of maternal plasma exosomes, a small size-class of EVs, are hypothesized to originate in the placenta, and may play a role in communication between the fetus and mother. However, few studies have addressed changes in miRNA over the course of pregnancy with repeated measures, nor focused on diverse populations. Read More

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High titers and low fucosylation of early human anti-SARS-CoV-2 IgG promote inflammation by alveolar macrophages.

Authors:

Sci Transl Med 2021 May 11. Epub 2021 May 11.

Patients diagnosed with coronavirus disease 2019 (COVID-19) become critically ill primarily around the time of activation of the adaptive immune response. Here, we provide evidence that antibodies play a role in the worsening of disease at the time of seroconversion. We show that early phase severe acute respiratory distress syndrome coronavirus 2 (SARS-CoV-2) spike protein-specific IgG in serum of critically ill COVID-19 patients induces excessive inflammatory responses by human alveolar macrophages. Read More

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Seizure in Children Under Five Presenting With Pneumonia in a Critical Care Ward in Bangladesh: Prevalence, Associated Factors, and Outcome.

Pediatr Infect Dis J 2021 May;40(5):389-393

From the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh.

Background: Pneumonia is the leading infectious cause of deaths in children under 5 for the last few decades. Development of seizure in those children is common and associated with increased risk of deaths. We therefore investigated the prevalence, associated factors and outcome of seizure in children hospitalized with pneumonia. Read More

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Intersection of Syphilis and HIV Networks to Identify Opportunities to Enhance HIV Prevention.

Clin Infect Dis 2021 May 12. Epub 2021 May 12.

Division of Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Background: HIV and syphilis infection continue at disproportionate rates among minority men who have sex with men (MSM) in the United States. The integration of HIV genetic clustering with partner services can provide important insight into local epidemic trends to guide interventions and control efforts.

Methods: We evaluated contact networks of index persons defined as minority men and transgender women diagnosed with early syphilis and/or HIV infection between 2018-2020 in two North Carolina regions. Read More

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ROP examination of premature babies at an eye hospital referred from urban and semi-urban NICUs.

Nepal J Ophthalmol 2020 Jul;12(24):226-235

Dr. Shroff's Charity Eye Hospital, 5027, Kedarnath Road, Daryaganj, Delhi.

Introduction: Retinopathy of prematurity (ROP) is seen in low gestational age (GA) and birth weight (BW) babies leading to retinal vascular damage. Screening of preterm would help in early identification of this, sight-threatening disease. Multiple factors play an important role in planning screening strategies for these preterm. Read More

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Maternal exposures and the infant gut microbiome: a systematic review with meta-analysis.

Gut Microbes 2021 Jan-Dec;13(1):1-30

Central Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales (NSW), Australia.

Early life, including the establishment of the intestinal microbiome, represents a critical window of growth and development. Postnatal factors affecting the microbiome, including mode of delivery, feeding type, and antibiotic exposure have been widely investigated, but questions remain regarding the influence of exposures on infant gut microbiome assembly. This systematic review aimed to synthesize evidence on exposures before birth, which affect the early intestinal microbiome. Read More

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Comprehensive analysis for detecting radiation-specific molecules expressed during radiation-induced rat thyroid carcinogenesis.

J Radiat Res 2021 May;62(Supplement_1):i78-i87

Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

Although the association between radiation exposure and thyroid carcinogenesis is epidemiologically evident, 'true' radiation-induced cancers cannot be identified from biological evidence of radiation-associated cases. To assess the individual risk for thyroid cancer due to radiation exposure, we aimed to identify biomarkers that are specifically altered during thyroid carcinogenesis after irradiation in a time-dependent manner in an animal model. Thyroid glands were obtained from rats (n = 175) at 6-16 months after local X-ray (0. Read More

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Association between duration of exclusive breastfeeding and nursing mothers' self-efficacy for breastfeeding.

Rev Esc Enferm USP 2021 10;55:e03702. Epub 2021 May 10.

Universidade Estadual do Oeste do Paraná, Programa de Pós-Graduação em Biociências e Saúde, Cascavel, PR, Brazil.

Objective: To verify the association of nursing mothers' self-efficacy for breastfeeding in the immediate postpartum period and six months after birth and obstetric and sociodemographic variables with the duration of exclusive breastfeeding.

Method: Observational, longitudinal, prospective study which followed nursing mothers from the immediate postpartum period to the sixth month postpartum in a municipality in Southern Brazil. For data collection, a questionnaire with sociodemographic and obstetric variables and the scale Breastfeeding Self-Efficacy Scale - short form - were employed in the maternity ward and six months after birth. Read More

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A novel human arterial wall-on-a-chip to study endothelial inflammation and vascular smooth muscle cell migration in early atherosclerosis.

Lab Chip 2021 May 12. Epub 2021 May 12.

School of Mechanical and Aerospace Engineering, Nanyang Technological University, Singapore, 639798, Singapore. and Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore.

Mechanistic understanding of atherosclerosis is largely hampered by the lack of a suitable in vitro human arterial model that recapitulates the arterial wall structure, and the interplay between different cell types and the surrounding extracellular matrix (ECM). This work introduces a novel microfluidic endothelial cell (EC)-smooth muscle cell (SMC) 3D co-culture platform that replicates the structural and biological aspects of the human arterial wall for modeling early atherosclerosis. Using a modified surface tension-based ECM patterning method, we established a well-defined intima-media-like structure, and identified an ECM composition (collagen I and Matrigel mixture) that retains the SMCs in a quiescent and aligned state, characteristic of a healthy artery. Read More

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Proton-pump inhibitors are associated with increased risk of prosthetic joint infection in patients with total hip arthroplasty: a case-cohort study.

Acta Orthop 2021 May 12:1-5. Epub 2021 May 12.

Department of Orthopedic Surgery, HagaZiekenhuis, Den Haag.

Background and purpose - Proton-pump inhibitors (PPI) have previously been associated with an increased risk of infections such as community-acquired pneumonia, gastrointestinal infections and central nervous system infection. Therefore, we evaluated a possible association between proton-pump inhibitor use and prosthetic joint infection (PJI) in patients with total hip arthroplasty (THA), because they can be stopped perioperatively or switched to a less harmful alternative.Patients and methods - A cohort of 5,512 primary THAs provided the base for a case-cohort design; cases were identified as patients with early-onset PJI. Read More

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Standard ECG in Brugada Syndrome as a Marker of Prognosis: From Risk Stratification to Pathophysiological Insights.

J Am Heart Assoc 2021 May 12:e020767. Epub 2021 May 12.

Cardiological Center University of Ferrara Italy.

Background The 12-lead ECG plays a key role in the diagnosis of Brugada syndrome (BrS). Since the spontaneous type 1 ECG pattern was first described, several other ECG signs have been linked to arrhythmic risk, but results are conflicting. Methods and Results We performed a systematic review to clarify the associations of these specific ECG signs with the risk of syncope, sudden death, or equivalents in patients with BrS. Read More

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Training the Trainers in Ultrasound-guided Access to Improve Peripheral Intravenous Catheter Placement among Children Presenting for Anesthesia.

Pediatr Qual Saf 2021 May-Jun;6(3):e406. Epub 2021 May 5.

Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, Wash.

Factors predicting difficult peripheral intravenous (PIV) catheter placement in children are known. Ultrasound guidance can decrease the number of attempts required for difficult PIV placement. However, the uptake of this technique among attending anesthesiologists at our institution remained low. Read More

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Sleeping Safely! A Quality Improvement Project to Minimize Nighttime Interruptions without Compromising Patient Care.

Pediatr Qual Saf 2021 May-Jun;6(3):e404. Epub 2021 May 5.

Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Va.

Sleep is crucial for patients' health but is often disrupted, slowing recovery and resulting in adverse health effects. This study identified whether passive vital sign checks (heart rate, respiratory rate, and pulse oximetry) and delayed routine morning laboratories in clinically stable pediatric patients minimized nighttime interruptions without compromising patient safety.

Methods: After developing the inclusion criteria using the Pediatric Early Warning Score, we enrolled eligible patients for the intervention. Read More

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Increased substance P and synaptic remodeling occur in the trigeminal sensory system with sustained osteoarthritic temporomandibular joint sensitivity.

Pain Rep 2021 1;6(1):e911. Epub 2021 Apr 1.

Department of Bioengineering, School of Engineering and Applied Science,University of Pennsylvania, Philadelphia, PA, USA.

Introduction: Temporomandibular joint (TMJ) pain is among the most prevalent musculoskeletal conditions and can result from atypical joint loading. Although TMJ pain is typically self-resolving, 15% of patients develop chronic TMJ pain that is recalcitrant to therapy and may be attributed to changes in pain processing centers. Although TMJ overloading induces pain and osteoarthritis, whether neuronal modifications in the trigeminal sensory system contribute to persistent TMJ pain is unknown. Read More

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Risk factors of ocular morbidity among under-five years old children in Khartoum State- Sudan- 2020.

Health Sci Rep 2021 Jun 3;4(2):e279. Epub 2021 May 3.

Preventive Medicine & Epidemiology Alneelain University Khartoum Sudan.

Background And Aims: Visual impairment in early childhood can significantly affect the development of visual, motor, and cognitive function and potentially lead to long-term adverse psychosocial consequences. This study aimed to identify the risk factors of ocular morbidity among under 5-year old children in Khartoum State, Sudan.

Methods: A cross-sectional study was conducted in three tertiary eye care hospitals in Khartoum State, Sudan. Read More

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Combining Serum DNA Methylation Biomarkers and Protein Tumor Markers Improved Clinical Sensitivity for Early Detection of Colorectal Cancer.

Int J Genomics 2021 21;2021:6613987. Epub 2021 Apr 21.

Department of Clinical Laboratory, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Nanjing, Jiangsu 210014, China.

Background: Colorectal cancer (CRC) is one of the leading causes of cancer deaths worldwide and in China. Early CRC screening is the best approach to reduce its incidence and mortality rates. The ColoDefense test, a multiplex qPCR assay simultaneously detecting both methylated and genes, has demonstrated improved clinical performance on either methylation biomarker alone for CRC screening with both blood and stool samples. Read More

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Tetrahydrobiopterin deficiencies: Lesson from clinical experience.

JIMD Rep 2021 May 1;59(1):42-51. Epub 2021 Feb 1.

Department of Pediatrics, Division of Pediatric Metabolism Ege University Faculty of Medicine Izmir Turkey.

Objectives: The present study describes clinical, biochemical, molecular genetic data, current treatment strategies and follow-up in nine patients with tetrahydrobiopterin (BH4) deficiency due to various inherited genetic defects.

Methods: We analyzed clinical, biochemical, and molecular data of nine patients with suspected BH4 deficiency. All patients were diagnosed at Ege University Faculty of Medicine in Izmir, Turkey and comprised data collected from 2006 to 2019. Read More

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A founder mutation in the gene in families from Saguenay-Lac-St-Jean region affected by a pyridoxine-dependent epilepsy.

JIMD Rep 2021 May 23;59(1):32-41. Epub 2021 Feb 23.

Centre de recherche CHU de Québec- Université Laval, Laval University Québec Québec Canada.

Pyridoxine-dependent epilepsy (PDE) is a relatively rare subgroup of epileptic disorders. They generally present in infancy as an early onset epileptic encephalopathy or seizures, refractory to standard treatments, with rapid and variable responses to vitamin B6 treatment. Whole exome sequencing of three unrelated families identified homozygous pathogenic mutation c. Read More

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Qualitative Interdisciplinary Learning Reviews of Non-COVID-19 Patients' Journeys During the COVID-19 Pandemic.

Cureus 2021 Apr 9;13(4):e14378. Epub 2021 Apr 9.

Quality and Patient Safety, Vancouver Coastal Health, Richmond, CAN.

In the early months of 2020, hospital processes were changed in response to the coronavirus disease 2019 (COVID-19) pandemic. We present one community hospital's experience in conducting a series of interdisciplinary learning reviews (ILRs) on non-COVID-19 patient's journeys during the early months of the pandemic. An ILR is a method of reviewing medical records using a system lens to identify system-level opportunities for improvement. Read More

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Telephone Fracture Clinic Consultations: A Satisfactory Solution in Lockdown.

Cureus 2021 Apr 8;13(4):e14371. Epub 2021 Apr 8.

Trauma and Orthopaedics, Southmead Hospital, Bristol, GBR.

Introduction The COVID-19 pandemic was a catalyst to many learning opportunities within clinical practice in the UK. Attempts were made to reduce footfall within all institutions and within the study unit; this led to alterations in fracture clinic provision. An alternative method was developed whereby most of the initial contacts were in person and much of the follow-up was done remotely. Read More

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Population growth lags in introduced species.

Ecol Evol 2021 May 9;11(9):4577-4587. Epub 2021 Mar 9.

Division of Tropical Environments and Societies James Cook University Townsville Qld Australia.

When introduced to new ecosystems, species' populations often grow immediately postrelease. Some introduced species, however, maintain a low population size for years or decades before sudden, rapid population growth is observed. Because exponential population growth always starts slowly, it can be difficult to distinguish species experiencing the early phases of slow exponential population growth (inherent lags) from those with actively delayed growth rates (prolonged lags). Read More

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